筛选细胞组合法预测红细胞同种抗体的临床应用

Clinical Application of Screening Cell Combination Method in the Prediction of Red Blood Cell Alloantibody

目的:探讨筛选细胞组合法鉴定红细胞血型抗体的应用,为临床诊断提供依据。方法:用全自动血型仪对2018年10月至2020年4月9 680例样本进行不规则抗体筛查,对79例同种抗体阳性者用其他3套不同厂家的筛选细胞组合法(简称组合法)进行鉴定,同时用谱细胞16系进行对比分析,分别比较两种方法鉴定结果的差异性。用组合法对WHO 4次室间质评12个样本和国家卫生健康委临床检验中心4次室间质评20个样本进行抗体筛查和抗体鉴定。结果:组合法鉴定抗体结果显示,在79例同种抗体阳性者中,抗-Mia 7例,抗-M 13例,抗-L^(e)a 9例,抗-P1 2例,抗-E 22例,抗-c+E 9例,抗-D 4例,抗-e 2例,抗-C+e 3例,抗C 3例,抗-H 1例,抗-Fy^(b) 1例,抗-E+M 1例,自身抗体+抗E抗体2例,而16系谱细胞鉴定结果中有7例抗-Mia抗体和1例抗-L^(e)a抗体漏检,组间比较差异无统计学意义。4次室间质评32例样本抗体筛查和鉴定结果准确率为100%。结论:组合法能满足中国人群临床红细胞不规则抗体鉴定的需要,可为临床诊断提供依据,筛选细胞同时可以用于不规则抗体的筛查,节省了试剂。

Objective: To explore the clinical application of screening cell combination method in the prediction of red blood cell alloantibody, so as to provide basis for clinical diagnosis. Methods: From October 2018 to April 2020, 9 680 samples were screened with automatic blood group instrument, 79 patients with positive alloantibodies were identified by 4 sets of screening cells from different manufacturers(referred to as combined method). At the same time, cell panel Panocell-16 was used for comparative analysis. Meanwhile, the combined method was also used to identify the antibodies of 20 samples from National Center for Clinical Laboratories external quality assessment(EQA) in China and 12 samples from WHO EQA. Results: The 79 alloantibodies included anti-Mia antibody(7 cases), anti-M antibody(13 cases),anti-L^(e)a antibody(9 cases), anti-P1 antibody(2 cases), anti-E antibody(22 cases), anti-c + E antibody(9 cases), anti-D antibody(4 cases), anti-e antibody(2 cases), anti-C + e antibody(3 cases), anti-C antibody(3 cases), anti-H antibody(1 case), anti-Fy^(b) antibody(1 case), anti-E + M antibody(1 case), autoantibody + anti-E(2 cases). However, 7 cases of antiMia antibody and 1 case of anti-L^(e)a antibody were missed in Panocell-16 identification results. The results of antibody identification in 20 samples from National Center for Clinical Laboratories EQA in China and 12 samples from WHO EQA were 100% accurate by combination method. The identification results between combined method identification and Panocell-16 identification showed no significant difference. Conclusion: The combined method can identify the alloantibodies of red blood cells in Chinese population. The screening cells can be used for screening of irregular antibodies without wasting reagents at the same time.